Background: Centenarian studies from around the world have shown that reaching age 100 typically involves substantial health issues. The present study adds to the existing knowledge from other countries by describing health conditions in German centenarians. Methods: A total of 112 centenarians or their primary contacts provided information on acute and chronic health conditions and pain in the context of the Second Heidelberg Centenarian Study (mean age = 100.45 years, Standard deviation [SD] = 0.47, 89% females). Results: Participants showed high comorbidity, with an average of five illnesses (mean = 5.3; SD = 2.20). Health conditions with highest prevalence were sensory (vision, hearing; 94%), mobility (72%) and musculoskeletal conditions (60%). Cardiovascular conditions (57%) and urinary system ailments (55%) were also common. Pain was experienced often by 30% of the participants. Of those reporting any pain, 36% indicated pain exceeding bearable levels. Conclusion: German centenarians experienced a substantial number of ill nesses, dominated by sensory and mobility conditions. Cardiovascular diseases were the only potentially lethal illnesses with high prevalence. Evidence of unaddressed pain seems alarming, requiring future research. Emerging health profiles indicate that even in very advanced age, quality of life may be improved by enhanced diagnostics and optimal disease management. Mobility limitations may be addressed with preventive efforts.